Lexapro vs. Paxil
See how Lexapro and Paxil compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Both are SSRIs, but Lexapro is approved for major depressive disorder in adolescents 12 to 17, while Paxil is approved only for adults.
Paxil covers a wider range of FDA-approved uses, including OCD, panic disorder, PTSD, and social anxiety disorder, while Lexapro is approved for depression and generalized anxiety disorder.
Paxil's common side effects occur at higher rates than Lexapro's, and its short half-life can make it harder to stop without withdrawal symptoms.
Lexapro vs. Paxil Drug Summary
Lexapro
Lexapro (escitalopram) is a selective serotonin reuptake inhibitor used to treat major depressive disorder in adults and adolescents 12 and older, as well as generalized anxiety disorder in adults. It's taken once daily as a tablet or oral solution, usually starting at 10 mg with an option to increase to 20 mg after two weeks.
Paxil
Paxil (paroxetine) is an SSRI approved for major depressive disorder, OCD, panic disorder, social anxiety disorder, generalized anxiety disorder, and PTSD in adults. It's taken once daily as a tablet, extended-release tablet, or oral suspension, with doses ranging from 20 mg up to 50 mg depending on the condition treated.
Lexapro vs. Paxil Side Effects
Lexapro
Paxil
Lexapro vs. Paxil Dosage
Lexapro
Paxil
| STAGE | DOSE | WHEN |
| Starting dose | 20 mg once daily | Week 2 onward |
| Maximum dose | 20 mg once daily | Same as starting |
| Dose changes | None | Fixed dose |
| STAGE | DOSE | WHEN |
| Starting dose | 20 mg once daily | At the start |
| Maximum dose | 20 mg once daily | Same as starting |
| Dose changes | None | Fixed dose |
Lexapro
| STAGE | DOSE | WHEN |
| Starting dose | 20 mg once daily | Week 2 onward |
| Maximum dose | 20 mg once daily | Same as starting |
| Dose changes | None | Fixed dose |
Paxil
| STAGE | DOSE | WHEN |
| Starting dose | 20 mg once daily | At the start |
| Maximum dose | 20 mg once daily | Same as starting |
| Dose changes | None | Fixed dose |
Lexapro vs. Paxil Indications
Lexapro
Lexapro is FDA-approved to treat major depressive disorder in adults and adolescents ages 12 to 17, along with generalized anxiety disorder in adults. It is not approved for depression in children under 12 or for any anxiety disorder in pediatric patients.
Major depressive disorder (adults and adolescents 12-17)
Generalized anxiety disorder (adults)
Not approved for MDD in children under 12
Not approved for GAD in pediatric patients
Paxil
Paxil is FDA-approved for a wider range of conditions, including major depressive disorder, obsessive-compulsive disorder, panic disorder, social anxiety disorder, generalized anxiety disorder, and PTSD in adults. It is not approved for use in any pediatric population.
Major depressive disorder (adults)
Obsessive-compulsive disorder (adults)
Panic disorder (adults)
Social anxiety disorder (adults)
Lexapro vs. Paxil Pros and Cons
Lexapro
Lexapro has a simpler once-daily dosing schedule with only one dose increase, and its side effect rates are generally lower than Paxil's. It also carries FDA approval for use in adolescents with depression, a group Paxil is not approved to treat.
Pros
Approved for depression in adolescents 12-17
Lower side effect rates than Paxil
Simple two-step dosing: 10 mg then 20 mg
Minimal CYP2D6 drug interaction risk
Cons
Narrower approval: only MDD and GAD
Roughly $440 to $603 per month, pricier than Paxil
No extended-release or oral suspension option
Paxil
Paxil covers a broader range of anxiety-related conditions than Lexapro, including OCD, panic disorder, and PTSD. Its side effect rates tend to run higher, and its strong CYP2D6 inhibition means it interacts with more medications than Lexapro does.
Pros
Approved for six conditions, including OCD, PTSD, panic disorder
Roughly $300 to $310 per month, less costly than Lexapro
Available as tablet, extended-release tablet, or oral suspension
Long safety record since FDA approval in 1992
Cons
Higher rates of nausea, somnolence, and dry mouth
Strong CYP2D6 inhibitor, complicating many drug combos
Short half-life linked to more difficult discontinuation
Common Symptoms and Related Diseases You Can Explore
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